醛固酮合酶基因-344C/T多态性预测原发性高血压合并早期肾损伤的价值

Role of aldosterone synthase gene -344C/T polymorphism in prediction of essential hypertension complicated with early renal injury

目的探讨醛固酮合酶(CYP11B2)基因-344C/T多态性预测原发性高血压(EH)合并早期肾损伤的价值。方法根据尿微量白蛋白/尿肌酐比值(UACR),394例EH患者分成高血压合并早期肾损伤(RD组,30mg/g≤UACR<300mg/g,154例)和高血压未合并早期肾损伤(NRD组,UACR<30mg/g,240例);40例健康志愿者作为对照组。比较各组相关临床指标、CYP11B2基因-344C/T基因型和等位基因频率,并分析EH合并早期肾损伤的影响因素。结果 RD组CC基因型频率低于NRD组,TT基因型和T等位基因频率高于NRD组(P<0.05);三组基因型和等位基因频率无统计学差异(P>0.05)。CT型和CC型患者SBP、DBP和血浆醛固酮(ALD)水平低于TT型(P<0.05),CC型患者ALD水平低于CT型(P<0.05)。Logistic回归分析显示,UACR与CYP11B2基因-344C/T基因型、SBP有关(P<0.05)。结论 EH患者合并早期肾损伤与CYP11B2基因-344C/T多态性有关,携带T等位基因的EH患者更容易产生早期肾损伤;基因检测可预示EH患者早期肾损伤。

Objective To investigate the role of aldosterone synthase gene（CYP11B2）-344C/T polymorphism in the prediction of essential hypertension（EH）complicated with early renal injury.Methods According to the urine bumin to creatinine ratio（UACR）,394 EH cases were divided into two groups of A（30mg/g≤UACR〈300mg/g,154cases）and B（UACR〈30mg/g,240cases）.Forty healthy volunteers were selected as the controls（group C）.The clinical parameters,genotype and allele frequencies of CYP11B2-344C/T were compared among three groups.The influence factors of EH complicated with early renal injury were analyzed.Results The frequency of CC genotype was lower,but the frequencies of TT genotype and T allele were higher,in group A than those in group B（P〈0.05）.There were no significant differences in genotype and allele frequencies among groups of A,B and C（P〉0.05）.The levels of SBP,DBP and ALD were lower in the patients with CC and CT genotypes than those in the patients with TT genotype（P〈0.05）.The level of ALD was lower in the patients with CC genotype than that in the patients with CT genotype（P〈0.05）.Logistic regression analysis showed that UACR was associated with the genotype of CYP11B2-344C/T and the level of SBP（P〈0.05）.Conclusion The EH complicated with early renal injury is associated with CYP11B2-344C/T polymorphism.Hypertensive patients with T allele develop early renal injury more easily.The gene detection can predict early renal injury in EH patients.